Provider Demographics
NPI:1285101915
Name:MCDONALD, DANIEL CHRISTOPHER (PA-C)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:CHRISTOPHER
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 FAIRMONT RD
Mailing Address - Street 2:
Mailing Address - City:RIEGELSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18077-7104
Mailing Address - Country:US
Mailing Address - Phone:215-510-0535
Mailing Address - Fax:
Practice Address - Street 1:1872 ST LUKES BLVD
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-5669
Practice Address - Country:US
Practice Address - Phone:484-503-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-31
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060117363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical